To protect the population at large against diseases, public health authorities generally aim to immunize 90 to 95 per cent of the population. To the dismay of the authorities, however, one segment of the population is surprisingly resistant to getting the flu and other vaccines recommended for them -- doctors, nurses and others working in the health care sector.

Public health authorities have good reason to want health care workers vaccinated -- they believe the vaccines will keep workers healthy, helping to protect patients while also saving the health care system money through fewer sick days. No less important, when highly knowledgeable people in the health care field balk at getting vaccines, they belie the common claim that only the misguided or misinformed question mass inoculation programs. As explained by Saskatchewan Health Minister Dustin Duncan, "It makes it harder for health officials, it makes it harder for me as the health minister to encourage people to get their vaccinations when they only see half of health care workers getting them."

Officialdom's failure to convince its own health care workers to follow its vaccination policy spans much of the Western world. In the UK, only 46 per cent of health care workers -- slightly less for doctors (45 per cent) and nurses (41 per cent) -- are vaccinated for the flu, despite concerted government efforts according to Public Health England. This startling failure is similar to that seen in Canadian jurisdictions for health care workers today, and those seen in the recent past in the U.S.

Public health officials in the U.S., though, have had success in the last five years by increasing pressure on health care workers, sometimes through laws mandating their vaccination, more often by making vaccines a requirement of employment. According to a Centers for Disease Control Internet survey, when employers remain neutral on vaccinations only 44% of health care workers get vaccinated. That figure rises to 70 per cent when the employer recommends it and 89 per cent when the employer requires it.

Now Canada may follow the U.S. lead in twisting the arms of its health care workers. Officials in Saskatchewan will consider mandatory measures next year if inoculation rates don't improve. British Columbia actually began mandatory measures last month, despite vehement opposition from various unions representing, among others, BC nurses, pharmacists and psychologists. In Alberta, where unvaccinated nurses have been told they may be sent home without pay during flu outbreaks, the government has promised to consider stronger medicine still if inoculation rates, currently at 40% to 50% for doctors, nurses and other health workers, don't improve.

Unvaccinated workers are also subject to psychological pressure. As of this month, Alberta's health ministry will be publicizing the vaccination rates of health workers at various facilities, a move whose "intent appears to be to shame or publicly embarrass workers into rolling up their sleeves," the Edmonton Journal states in an article decrying "quack pseudo-science [that insists] the flu vaccine is dangerous or ineffective, a Big Pharma conspiracy." Such strong medicine is necessary because when "health workers refuse vaccination, it feeds the paranoia, suggesting immunization must be dangerous after all."

Alberta's chief medical officer, Dr. James Talbot, seems to agree: He has marginalized some of his province's health workers as being "in a sense of denial" about flu risks and alluded to an irrational or ideological opposition from "a small number of them [who] are actually opposed to immunization." This kind of talk gets pushback from professionals who decry the ad hominem attacks.

Stated National Nurses United president Karen Higgins last year, "nurses, joined by many physician organizations and researchers, reject the notion that vaccination is a fail-safe solution to prevent the spread of the flu virus... there are health reasons why some elect not to be vaccinated. Some vaccine products have been withdrawn, as when Bell's palsy developed for many recipients. It has just been reported that 800 European children contracted narcolepsy, an incurable sleep disorder, after receiving the swine flu vaccine." The notion that the flu vaccine can be both ineffective and harmful, a CDC survey confirms, is common among health care workers.

In the immunization wars between health care workers and the government public health authorities, the government authorities are inexorably advancing -- in British Columbia, for example, early indications are that workers are grudgingly acceding to their employers' demands, sometimes more than doubling their compliance rates, from 30 per cent to 75 per cent. In the U.S., the CDC has gained ground in pushing for mandatory universal vaccinations of health care workers against pertussis, measles, and a host of other infectious diseases. If governments ultimately succeed in this quest, they will have eliminated the argument that health professionals shun vaccinations for themselves and be one step closer to their ultimate goal -- to make universal vaccinations mandatory in the general public.

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Flu Myths

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Fact: This myth just will not die. So let's clear this up: You cannot get the flu from your flu shot.
Why? That vaccine is made from a dead or inactive virus that can no longer spread its fever-spiking properties. In rare cases, a person may experience a reaction to the shot that includes a low-grade fever, but these reactions are not The Flu, Everyday Health reported. Note: Even though the flu shot cannot cause the flu, there are a number of other reasons not to get the vaccine, including for some people with an allergy to eggs or a history of Guillain-Barre Syndrome.

Fact: Unfortunately, even after slapping a bandage on that injection site, you may only be about 60 percent protected, according to the CDC. That means, yes, you can still get the flu after your shot. Some people may be exposed to the flu in the two weeks it takes for the vaccine to take effect, reports NPR. Others might be exposed to a strain not covered in the vaccine, which is made each year based on the viruses experts predict will be the most common, according to Flu.gov. (This year's batch seems to have been matched well to what is actually going around, NPR reports.)

Fact: Plain and simply, antibiotics fight bacteria, not viruses. The flu -- and colds, for that matter -- are caused by viruses. In fact, antibiotics kill off the "good" bacteria that help to fight off infections, so that viral flu may only get worse.

Fact: Nausea, vomiting or diarrhea, while often dubbed the "stomach flu," are not typically symptoms of seasonal influenza, which, first and foremost, is a respiratory disease, according to Flu.gov. The flu can sometimes cause these issues, but they won't usually be the main symptoms -- and are more common signs of seasonal flu in children than adults.

Fact: Younger, healthy adults aren't among the people the CDC urges most strongly to get vaccinated, like pregnant women, people over 65 and those with certain chronic medical conditions.
The young and healthy will more often than not recover just fine from the flu, with or without the shot. But protecting yourself even if you don't think you need protecting can actually be an act of good. The more people are vaccinated, the fewer cases of flu we all pass around, which in turn offers greater protection to those at-risk groups.

Fact: Mom or Grandma probably told you this one at some point, and while you might not feel so cozy if you head out the door straight from the shower, doing so doesn't exactly condemn you to bed. The only way to catch the flu is to come into contact with the virus that causes it. That might happen while you are outside in the cold, and flu season does certainly happen during cold weather, but it's not because you're cold that you catch the bug.

Fact: It's not antibiotics that cure-seekers should be looking for. While the two antiviral drugs available to fight the flu aren't a quick fix, they can reduce the length of your bout of the flu and make you less contagious to others, according to WebMD. This year's earlier-than-usual flu season has already led to shortages of one of the drugs, Tamiflu, in the children's liquid formulation, according to the medication's manufacturers.
However, a number of experts in countries around the world have questioned Tamiflu's efficacy in fighting the flu, and some have even suggested a boycott until further data is published.